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유리비골피부피판을 이용한 두경부 재건 시 CT Angiography를 통한 천공지의 확인

Preoperative Identification of Perforator Using CT Angiography in Fibular Osteocutaneous Free Flap Head and Neck Reconstruction

  • 장택진 (울산대학교 의과대학 서울아산병원 성형외과학교실) ;
  • 김은기 (울산대학교 의과대학 서울아산병원 성형외과학교실) ;
  • 최종우 (울산대학교 의과대학 서울아산병원 성형외과학교실)
  • Chang, Tack-Jin (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Eun Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Jong Woo (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.02.10
  • 심사 : 2012.03.20
  • 발행 : 2012.04.09

초록

Purpose: Fibular osteocutaneous free flap is the procedure of choice for mandibular reconstruction. However, the anatomic consistency and the reliability of the skin paddle have been considered to be questionable and the utilization of the fibular osteocutaneous free flap can be challenging for the inexperienced surgeon. Preoperative computed tomography (CT) angiography can support revolutionary help with the operator design of the fibular osteocutaneous flap. The purpose of this article is to share the valuable experience of support with preoperative CT angiography. Methods: Three consecutive patients, who needed mandibular reconstruction, were treated with fibular osteocutaneous free flap. Each of the patients had undergone lower extremity CT angiography before the surgery. The CT angiographies were scrupulously investigated to calculate the locations and the tracts of the peroneal artery perforators. We compared the findings of the CT angiography with those of the real operation. Results: The information about the perforators was sufficiently matched with the findings of the operation. With the use of preoperative CT angiography, we were able to achieve confident performance during operation, shortening of operation time, and fine outcomes with a no flap failure. Conclusion: The CT angiography of lower extremity can provide reliable information of the perforators of the fibular osteocutaneous free flap.

키워드

피인용 문헌

  1. Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels vol.2, pp.1, 2012, https://doi.org/10.1186/s41747-017-0033-2